testosterone

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Trade Name(s): Depo-testosterone; Jatenzo; Kyzatrex; Natesto; Testopel; Tlando; Xyosted; Fortesta; Testim; Testosterone; Vogelxo
Group 2: Non-Antineoplastic Hazardous AHFS Class: Androgens
Formweb: testosterone
Info Links: Chemotherapy Extravasation Policy
Injectable = vial, syringe, IV solution, irrig solution, ampule - NN & RR (LH))
ActivityGloveGownEyeMask (N95/PAPR)CSTD
AdministrationGloves Single

Goggles

If splashing

possible

Mask

If inhalation

possible

Waste/Disposal of drugGloves Single

Goggles

If splashing

possible

Mask

If inhalation

possible

Nursing Non-Antineoplastic or Reproductive Risk Drug PPE and Work Practices (Link to a file uploaded to Rhazdrugs or to a file on your intranet, or a shared drive.)

Topical
ActivityGloveGownEyeMask (N95/PAPR)
Administration

Gloves Double

single glove  if only applying

from intact form (i.e., patch, device)

Gown

Goggles

If splashing

possible

Mask

If inhalation

possible

Waste/Disposal of drugGloves DoubleGownGoggles
If splashing
possible
Mask
If inhalation
possible

NN & RR - PPE During Handling of Bodily Fluids, contaminated materials (LH)

Handling of bodily fluids and/or contaminated materials

Drug FormGloveGownEyeMask (N95/PAPR)Shoe
Intact tablet or capsule from UD packageGloves Single
Non-intact, repackaged tablet or capsuleGloves Single
Oral liquid drug or feeding tubeGloves Single
Topical drugGloves DoubleGown
If splashing
possible
Goggles
If splashing
possible
Mask
If inhalation
possible
Powder, solution for inhalationGloves SingleGownGoggles
Mask
Vial; ampule; pre-filled syringeGloves SingleGoggles
If splashing
possible
Mask
If inhalation
possible
Intravenous solutionsGloves SingleGoggles
If splashing
possible
Mask
If inhalation
possible
Irrigation solutionsGloves SingleGoggles
If splashing
possible
Mask
If inhalation
possible


Non-antineoplastics & Reproductive Risk Only Drugs (LH)

Receiving and Storage:
NN & RR-Receiving & Storage (LH)
Form      Receipt PackagingEnvironmentGloveStorageLabeling
All FormsNo additional actionNo additional actionGloves SingleMay be stored within normal inventory, neutral or positiveCautionary Labeling

Pharmacy Non-Antineoplastic or Reproductive Risk Drugs PPE and Work Practices

Injectable NN & RR (LH)
GloveGownEyeResp ShoeHeadHood/CabinetCSTD
Gloves Double
(outer layer should be sterile)
GownMask SurgicalShoe CoversHair Cover

Laminar Air Flow Hood

LAFW

Pharmacy Non-Antineoplastic or Reproductive Risk Drugs PPE and Work Practices

Topical ALL-Intact, no manipulation (LH)
GloveGownEyeMask (N95/PAPR)ShoeHood/CabinetCSTD
Gloves Single

*NO Manipulation

Transport of NN & RR (LH)
FormPrep Instructions

Pneumatic

Tube

Intact tablet/capsule from UD packageSealed plastic bag, single pair of gloves, cautionary labelingTube Ok
Non-intact, repackaged tablet or capsuleSealed plastic bag, single pair of gloves, cautionary labeling
Tube Ok
Oral liquid drug or feeding tubeSealed plastic bag, single pair of gloves, cautionary labeling
Do Not Tube
Topical drugSealed plastic bag, single pair of gloves, cautionary labeling
Tube Ok
Powder, solution for inhalationSealed plastic bag, single pair of gloves, cautionary labeling
Tube Ok
Vial; ampule; pre-filled syringeSealed plastic bag, single pair of gloves, cautionary labeling
Do Not Tube
Intravenous solutionSealed plastic bag, single pair of gloves, cautionary labeling
Do Not Tube
Irrigation solutionSealed plastic bag, single pair of gloves, cautionary labeling
Do Not Tube

Assessment of Risk:
Dosage FormRisk of ExposurePackagingPharmacy ManipulationNurse Manipulation
InjectableMay occur when withdrawing from vial and administrationVialDispense in intact packaging or admixture in LAFWIf preparing in patient care area, utilize PPE as stated in handling guide.
TopicalMay occur when administeringTopical emulsion in single dose packagingDispense in intact packagingNone
ImplantMay occur when implantingImplant in single dose packagingDispense intact packagingIf preparing in patient care area, utilize PPE as stated in handling guide.


PPE Guidelines
Gloves DoubleGownFace ShieldGoggles
MaskPap Respirator
Hair CoverShoe Covers Double
Chemotherapy rated/tested
(tested to ASTM D6978-05 (2013), Standard Practice for Assessment of Resistance of Medical Gloves to Permeation by Chemotherapy Drugs)
Disposable
  • must not be reused
Should be worn in situations where eye, mouth, or nasal splashing is possible (i.e., during a bladder instillation of a hazardous drug)Goggles protect the eyes, but not the face, against spraying.Certified N95Powered air purifying respiratorrequired for compounding sterile and nonsterile hazardous drugsrequired for compounding sterile and nonsterile hazardous drugs
Powder-freeShown to resist permeation by hazardous drugs
  • material: polyethylene-coated polypropylene or other laminate materials
N95 offers no protection against gases and vapors.For events such as large spills when an IV bag breaks or a line disconnects and leaks, or where there is known or suspected airborne exposure to vapors or gasesDouble booties required for HD preparation areas, top layer is doffed before exiting the HD buffer room.
Inspect for visible defectsMust close in the back
(no open front)
Surgical masks do NOT provide respiratory protection from drug exposureHazardous drugs with potential to vaporize at room temperature:
• Carmustine
• Cisplatin
•Cyclophosphamide
• Etoposide
• 5-Fluorouracil
• lfosfamide
• Thiotepa
Double gloving is recommended for all activities involving hazardous drugs except for handling intact, unit-dose oral agents, when one pair of chemotherapy-tested gloves is acceptableLong sleeves with closed cuffs that are elastic or knit
When wearing double gloves, tuck the cuff of the inner glove under the gown sleeve and the cuff of the outer glove over the gown sleeve.No seams or closures that could allow hazardous drugs to pass through
During medication manipulation/compounding the outer layer should be sterileIn preparation areas gowns should be changed every 2-3 hours or immediately after a spill or splash
Change gloves every 30 minutes unless permeation testing has noted shorter time limits
  • change gloves immediately if damaged or contaminated
Gowns worn in hazardous drug handling areas must NOT be worn to other areas


Sequence for Donning & Doffing PPE

References: Oncology Nursing Society, NIOSH

Mechanism of Action:

Testosterone mediates its effects by activating androgen receptors directly or as DHT, or being converted to estradiol which acts as an endogenous lignad on estrogen receptors. Free testosterone (T) is transported into the cytoplasm of target tissue cells, where it can bind to the androgen receptor, or can be reduced to 5α-dihydrotestosterone (DHT) by the cytoplasmic enzyme 5α-reductase. DHT displays an androgenic potency that is about 2.5 times higher than to that of free T. Upon formation, the T-receptor or DHT-receptor complex undergoes a structural change that allows translocation of the complex into the cell nucleus and direct binding to the specific nucleotide sequences of the chromosomal DNA as a transcription factor. These specific nucleotide sequences are also called hormone response elements (HREs) that, when activated, promote transcriptional activity of certain genes responsible for the androgen effects.

Reference: Drug Bank

Exposure Risk:
  • Harmful if swallowed
  • May cause cancer 
  • Suspected of causing cancer 
  • May damage fertility or the unborn child 
  • Suspected of damaging fertility or the unborn child
  • May cause harm to breast-fed children 
  • Causes damage to organs through prolonged or repeated exposure 
  • Very toxic to aquatic life 
  • Very toxic to aquatic life with long lasting effects 

Reference: PubChem

Supplemental Information:

CSA SCH: C-III

Approved on September 12, 2024